Evaluation of potential biomarkers for traditional Chinese medicine-based chronic heart failure syndromes: A case-control study

Introduction
The recognition of serum biomarkers for differentiation between traditional Chinese medicine (TCM) syndromes would greatly increase the objectivity and treatment results. The objective of this study was to identify whether adiponectin (ADIPOQ), insulin-like growth factor binding protein 2 (IGFBP-2), and insulin-like growth factor binding protein 4 (IGFBP-4) are reliable biomarkers for differentiation between the heart-yang deficiency and heart-yin deficiency syndromes of TCM-based chronic heart failure.
Methods
Serum samples of 25 heart-yang deficiency patients, 25 heart-yin deficiency patients, and 25 healthy participants were analyzed. The participants were also subjected to blood pressure measurements and laboratory testing of the variables creatinine, CRP, BNP, NT-proBNP, IGFBP-2, ADIPOQ, and IGFBP-4. ELISA assays were performed to confirm the expression patterns of IGFBP-2, ADIPOQ, and IGFBP-4. ANOVA was used to compare variables between groups and the Tukey's Test was applied to statistically significant results for post-hoc analysis. Logistic regression analysis was used to evaluate the relationship between IGFBP-4 and dichotomous variables, while linear regression analysis was used to evaluate continuous variables. A receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic ability of IGFBP-4.
Results
The ELISA results showed that only IGFBP-4 was significantly up-regulated (p < 0.01) in heart-yang deficiency patients, while ADIPOQ and IGFBP-2 were significantly upregulated in both groups. The ROC curve suggested that the area under the curve value of IGFBP-4 was as high as 0.969.
Conclusions
The results suggest IGFBP-4 may have diagnostic value as a potential biomarker for clinical differentiation between heart-yin deficiency and heart-yang deficiency patients.

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